改良肛门镜与荷包式肛门镜在吻合器痔固定术的比较。
Comparison of a modified anoscope and the purse-string anoscope in stapled haemorrhoidopexy.
机构信息
Third Surgical Clinic of Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
出版信息
World J Gastroenterol. 2009 Nov 28;15(44):5573-8. doi: 10.3748/wjg.15.5573.
AIM
To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy.
METHODS
The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared.
RESULTS
Operation time was significantly longer in Group 1 (42.0 +/- 8.4 min vs 27.7 +/- 8.0 min, P = 0.039). The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P < 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034).
CONCLUSION
Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.
目的
比较吻合器痔上黏膜环切术（PPH）中使用 PPH 套件肛门镜和改良肛门镜的效果。
方法
回顾 2001 年至 2006 年间行吻合器痔上黏膜环切术的 37 例患者的病历。15 例患者使用 PPH 套件中的荷包缝合肛门镜（第 1 组），22 例患者使用改良肛门镜（第 2 组）。比较两组患者的一般资料、手术时间、术者操作感受、镇痛需求及并发症等。
结果
第 1 组的手术时间明显长于第 2 组（42.0 ± 8.4 min 比 27.7 ± 8.0 min，P = 0.039）。术者认为第 2 组的操作感受明显优于第 1 组（第 1 组中 10 例评估结果为差、4 例为中、1 例为好，而第 2 组中所有患者均为好，P < 0.001）。第 1 组需要止血缝线的比例明显高于第 2 组（6 例），第 2 组需要 2 例（P = 0.034）。
结论
使用改良肛门镜可缩短手术时间，增加术者满意度，而且如果术者在击发吻合器前后等待时间更长，则需要的止血缝线更少。
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